Headache Classification Subcommittee of the International Headache Society (IHS) The International Classification of Headache Disorders 2nd Edition 1st revision (May, 2005) Copyright ©International Headache Society 2003-2005. Applications for copyright permissions should be submitted to Blackwell Publishing, 9600 Garsington Road, Oxford 0X4 2DQ, UK (phone +44 1865 776868; fax +44 1865 714591; www.blackwellpublishing.com). The International Classification of Headache Disorders, 2nd edition, may be reproduced freely for scientific or clinical uses by institutions, societies or individuals. Otherwise, copyright belongs exclusively to the International Headache Society. Reproduction of any part or parts in any manner for commercial uses requires the Society’s permission which will be granted on payment of a fee. Please contact the publisher at the address above. Permission for translations must be applied for, and will be granted to National Headache Societies or Linguistic Groups of the International Headache Society. In the absence of a National Headache Society or Linguistic Group, a headache expert may be approved on behalf of the International Headache Society by the Chairman of the Headache Classification Subcommittee to be responsible for translation into a specific language. Sponsorships may be listed and advertisements accepted in translations. The International Classification of Headache Disorders, 2nd edition (Cephalalgia 2004; 24 suppl 1: 1-160) may be purchased from Blackwell Publishing, 9600 Garsington Road, Oxford 0X4 2DQ, UK (phone +44 1865 776868, fax +44 1865 714591, www.blackwellpublishing.com). Discounts are available for bulk purchase. The subsequent 1st revision, which makes changes only to section 8.2, is published separately (Cephalalgia 2005; 25: 460-465) and may likewise be purchased from Blackwell Publishing. 2 First Headache Classification Subcommittee Members Jes Olesen, Denmark (Chairman) André Bes, France Robert Kunkel, USA James W Lance, Australia Giuseppe Nappi, Italy Volker Pfaffenrath, Germany Frank Clifford Rose, United Kingdom Bruce S Schoenberg, USA (deceased) Dieter Soyka, Germany Peer Tfelt-Hansen, Denmark (Secretary) K Michael A Welch, USA Marica Wilkinson, United Kingdom Second Headache Classification Subcommittee Members Jes Olesen, Denmark (Chairman) Marie-Germaine Bousser, France Hans-Christoph Diener, Germany David Dodick, USA Michael First, USA Peter J Goadsby, United Kingdom Hartmut Göbel, Germany Miguel JA Lainez, Spain James W Lance, Australia Richard B Lipton, USA Giuseppe Nappi, Italy Fumihiko Sakai, Japan Jean Schoenen, Belgium Stephen D Silberstein, USA Timothy J Steiner, United Kingdom (Secretary) 3 Members of Headache Classification Working Groups and Advisors Please address comments and suggestions to the relevant working-group chairmen with a copy to: Jes Olesen Chairman of the Classification Subcommittee of the International Headache Society Professor of Neurology, University of Copenhagen Department of Neurology Glostrup Hospital, 2600 Glostrup, Copenhagen, Denmark 1. Working group on Migraine: RB Lipton, USA (chairman); R Daroff, USA; J Haan, The Netherlands; H Massiou, France; J Olesen, Denmark; J Pascual, Spain; BK Rasmussen, Denmark; SD Silberstein, USA; S Solomon, USA; TJ Steiner, United Kingdom; D Symon, United Kingdom; P Winner, USA. Advisors: MK Eriksen, Denmark; P Goadsby, United Kingdom; S Graff-Radford, USA; JW Lance, Australia; LL Thomsen, Denmark. 2. Working group on Tension-Type Headache: J Schoenen, Belgium (Chairman); EA MacGregor, United Kingdom; K Holroyd, USA; R Jensen, Denmark; N Mathew, USA; J Olesen, Denmark; T Paiva, Portugal; R Pothmann, Germany; P Sandor, Switzerland; G Sandrini, Italy. 3. Working group on Cluster Headache and Other Trigeminal Autonomic Cephalalgias: P Goadsby, United Kingdom (Chairman); F Antonaci, Italy; A Bahra, United Kingdom; D Dodick, USA; MS Matharu, United Kingdom; A May, Germany; J Olesen, Denmark; L Newman, USA; J Pareja, Spain; D Rothner, USA; M-B Russell, Denmark; M Vincent, Brazil; E Waldenlind, Sweden. Advisor: CJ Boes, USA. 4. Working group on Other Primary Headaches: G Nappi, Italy (Chairman); P Goadsby, United Kingdom; JW Lance, Australia; PO Lundberg, Sweden; IP Martins, Portugal; J Olesen, Denmark; JA Pareja, Spain; NH Raskin, USA; G Sandrini, Italy; TJ Steiner, United Kingdom; A Straube, Germany. Advisors: L Bonamico, Argentina; S Evers, Germany. 5. Working group on Headache Attributed to Head and/or Neck Trauma: M Lainez, Spain (Chairman); R Agosti, Switzerland; F Antonaci, Italy; D Dodick, USA; R Evans, USA; A Mosek, Israel; R Nelson, Canada; D Obelieniene, Lithuania; N Ramadan, USA; 4 J Pascual, Spain; P Sandor, Switzerland. 6. Working group on Headache Attributed to Cranial or Cervical Vascular Disorder: M-G Bousser, France (Chairman);J-P Castel, France; A Ducros, France; J Ferro, Portugal; S Kittner, USA; H Mattle, Switzerland; J Olesen, Denmark; S Solomon, USA. 7. Working group on Headache Attributed to Non-Vascular Intracranial Disorder: H-C Diener, Germany (Chairman);M-G Bousser, France; D Dodick, USA; A Dowson, United Kingdom; P Drummond, Australia; J Gladstein, USA; A Mosek, Israel; R Nelson, Canada; J Olesen, Denmark; N Ramadan, USA; K Ravishankar, India; P Sandor, Switzerland; SD Silberstein, USA; J Swanson, USA; F Taylor, USA; L Watkins, United Kingdom. 8. Working group on Headache Attributed to a Substance or its Withdrawal: S Silberstein, USA (Chairman);H-C Diener, Germany; M Ferrari, The Netherlands; J Olesen, Denmark; JM Pereira Monteiro, Portugal; J Saper, USA; F Sheftell, USA; P Tfelt-Hansen, Denmark; WB Young, USA. 9. Working group on Headache Attributed to Infection: F Sakai, Japan (Chairman); M De Marinis, Italy; A Pradalier, France; D Russell, Norway; N Suzuki, Japan; JR Weber, Germany; KMA Welch, USA. Advisor: E Schmutzhard, Austria. 10. Working group on Headache Attributed to Disorder of Homoeostasis: D Dodick, USA (Chairman); W Becker, Canada; G Bussone, Italy; D Capobianco, USA; FM Cutrer, USA; J Edmeads, Canada; A Kuritzky, Israel; J Olesen, Denmark; A Purdy, Canada; P Spira, Australia. 11. Working group on Headache or Facial Pain Attributed to Disorder of Cranium, Neck, Eyes, Ears, Nose, Sinuses, Teeth, Mouth or Other Facial or Cranial Structures: H Göbel, Germany (Chairman); M Bakke, Denmark; RW Baloh, USA; N Bogduk, Australia; RB Daroff, USA; S Graff-Radford, USA; J Olesen, Denmark; D Soyka, Germany. Advisors: H Blumenthal, USA; G Deuschl, Germany; HL Levine, USA; NT Mathew, USA. 12. Working group on Headache Attributed to Psychiatric Disorder: MB First, USA (Chairman); RM Agosti, Switzerland; S Baskin, USA; N Breslau, USA; V Guidetti, Italy; J Olesen, Denmark; F Sheftell, USA. 13. Working group on Cranial Neuralgias and Central Causes of Facial Pain: J Lance, Australia (Chairman); D Bowsher, United Kingdom; KL Casey, USA; J Olesen, Denmark; T Staehelin-Jensen, Denmark; A Zagami, Australia. 5 14. Working group on Other Headache, Cranial Neuralgia and Central or Primary Facial Pain: D Dodick, USA (Chairman); J Olesen, Denmark. 6 Acknowledgements The work of the Headache Classification Subcommittee of the International Headache Society is financially supported exclusively by the International Headache Society. The International Headache Society expresses its gratitude for unrestricted grants given to the Society with a view to supporting its activities, including The International Classification of Headache Disorders, 2nd edition, by the following companies: Pfizer Merck Allergan Boots Healthcare International Vernalis The headache classification subcommittee and its working groups have received valuable suggestions and critiques from a great number of colleagues around the world. They cannot all be acknowledged individually but we wish to mention two specifically. Robert Spitzer’s immense experience in psychiatric disease classification inspired the reconstituted headache classification subcommittee at its first meeting. Michael B First is a psychiatrist and an expert in disease classification. He has been invaluable as an outside expert, early on helping the many new members who were unfamiliar with disease classification and, later, often guiding our steps in this difficult art. Despite the fact that headache is remote to his speciality he graciously accepted to chair a newly-formed working group on headache attributed to psychiatric disease. Peter Goadsby, Richard B Lipton, Jes Olesen and Stephen D Silberstein have organised the practical aspects of our meetings. Kirsten Hjelm has done most of the administrative and secretarial work for the subcommittee. Rosemary Chilcott has managed the finances. We thank both for their never-failing support. 7 Table of Contents p Preface to the first edition 9 Preface to the second edition 10 Preface to the first revision 12 Introduction 13 How to use the classification 16 Classification 19 Part One: The Primary Headaches 1. Migraine 28 2. Tension-type headache 50 3. Cluster headache and other trigeminal autonomic cephalalgias 61 4. Other primary headaches 70 Part Two: The Secondary Headaches Introduction 82 5. Headache attributed to head and/or neck trauma 84 6. Headache attributed to cranial or cervical vascular disorder 94 7. Headache attributed to non-vascular intracranial disorder 113 8. Headache attributed to a substance or its withdrawal 130 9. Headache attributed to infection 154 10. Headache attributed to disorder of homeostasis 162 11. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses,